Challenges In Utilization Of Electronic Medical Recording System At SPHMMC: Cross Sectional Study

Abstract

Abstract Background: Electronic Medical Record (EMR) systems play a critical role in improving healthcare quality through enhanced clinical documentation, patient safety, continuity of care, and data-driven decision-making. In Ethiopia, EMR implementation has been prioritized under national digital health transformation strategies. Despite system deployment in major public hospitals, effective utilization remains inconsistent. Saint Paul Hospital Millennium Medical College (SPHMMC), one of the largest tertiary teaching hospitals in Addis Ababa, introduced EMR to modernize healthcare delivery; however, practical challenges affecting optimal use have not been adequately studied. Objective: This study aimed to identify and analyze the key technical, human-related, and organizational challenges hindering effective utilization of the EMR system among healthcare professionals at SPHMMC. Methods: An institution-based cross-sectional study was conducted from June to November 2025 among healthcare professionals directly involved in patient care at SPHMMC. A stratified random sampling technique was applied across major clinical departments. A total sample size of 369 participants was determined using a single population proportion formula with finite population correction and a 10% non-response adjustment. Data were collected using a structured, self-administered questionnaire assessing socio-demographic characteristics, EMR utilization patterns, computer literacy, training exposure, infrastructural conditions, and organizational support. Data were coded and analyzed using SPSS version 26. Descriptive statistics summarized participant characteristics and utilization patterns, while regression analysis identified factors associated with perceived EMR utilization challenges. Statistical significance was declared at p-value <0.05. Results: The study included 369 healthcare professionals with a nearly equal gender distribution and a mean age of 39.44 years (SD ±7.36). Physicians and nurses constituted the largest professional groups (32.79% each). Major challenges identified included lack of structured EMR training, reported by 94% of participants, resulting in reliance on peer-to peer learning and self-directed skill acquisition. Technical barriers such as delayed laboratory result availability (24–72 hours), system navigation difficulties, and workflow inefficiencies significantly affected clinical decision-making, particularly in emergency and high-patient volume departments. Organizational limitations, including inadequate technical support and inconsistent integration of EMR into departmental workflows, further contributed to reduced efficiency. Human factors such as varying computer literacy levels and negative user experiences were also associated with higher perceived challenge scores. Conclusion: EMR utilization at SPHMMC is affected by multifactorial challenges involving insufficient training, infrastructural limitations, system usability concerns, and organizational support gaps. Addressing these barriers through structured capacity-building programs, improved technical infrastructure, workflow customization, and strengthened institutional support mechanisms is essential to optimize EMR functionality and enhance healthcare service delivery. Key words: Electronic Medical Record (EMR) Utilization,EMR Utilization Challenges, Health Information Systems (HIS), Digital Health Transformation, Healthcare Professional Computer Literacy, Organizational and Technical Barriers, Clinical Workflow Integration, Healthcare Professional Training and Capacity Building, Tertiary Healthcare Hospital Setting, Saint Paul Hospital Millennium Medical College (SPHMMC), Ethiopia